HomeMy WebLinkAboutBLD2023-01327 - BLD CD Environmental Health Review - 11/3/2023 . , (-4-1 r- 5-.' MASON COUNTY PermitNo:� �', -DI3 7 •
COMMUNITY DEVELOPMENT RCC` 1V EE
m
Permit Assistance Center, Building,Planning `;OV 0 3 2023 Z
BUILDING PERMIT APPLICATION A
615 W.. A.I..�1f 1r Street= 73
PROPERTY OWNER INFORMATION: CONTRACTOR INFORMATION: m O
•
NAME:k.4111-4' 1-4eci CV)C Lc)bh NAME: _ > Z
MAILING ADDRESS:fit)5!Jt l✓u_.1 ,4 V MAILINCI AIX/K _SS:.
brekner-ton) CITY: Naidoli v,r STATE' 4 ZIP:4iSirgigl CITY:4 STATE: _ZIP: rn
PHONE#1:3 - • -3► •5 PHONE: CELL:
CLh '
PHONE#2: g 0 : '2)_� 9 ' EMAIL:
EMAIL:kAvIil Lt,i 0 in-n . Lcir'1'► Uzi REG# EXP. / /_
PRIMARY CONTACT: OWNER CONTRACTOR OTHER❑ ��
NAME R.Z.Y i ..-1•1 ert )t�Ct
j1- EMAIL K ✓11 i.)b •-4�
MAILING ADDRESS .1 t 5 jUiV t it 1 kw'_/'ki 2.-- 'CITY ' , ' STATE7y✓A ZIP ' NOV 0 6 20Z3
PHONE ... -COI-3 /C c CELL4--
•
PARCEL INFORMATION: A 2 1 I RECEIVED
PARCEL NUMBER(12 Digit Number) rAZ4 3�r 1 t_OD1 0 ZONING A�R/CU/7W 1.
LEGAL DESCRIPTION(Abbreviated)/-(,14 Cake(Lt'D FIRE DISTRICT 14`A-24-5 II in ■ '5 EC.t✓16
SITE ADDRESS;Ct-4 I L Ct'3 T j u el<f 14-/I I (Z{oct[;1 CITY PSI-f p,'1 yt)f� t-5"•
DIRECTIONS TO SITE ADDRESS I-tt cr i-5 -iy1P,r-�1.4-f1/4 l t� --Cr ,,S Ljr't� •-1 t't J'v 1,_-e_
a c+ +-he" 5ki() rii( - Da.AueTo "�.is(f 1471► t2.cf cc Iit; ,,.r,[ to [( I
IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES❑ NO X SNOW LOARS. f'F
IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that appli: �/�pl�►�
SALTWATER❑ LAKE❑ RIVER/CREEK 0 POND❑ WETLAND❑ SEilfA e RUNOFF STREAM❑
TYPE OF WORK: NEW$ ADDITION❑ ALTERATION❑ REPAIR❑ OTHER 0
USE OF STRUCTURE(Residence,Garage,Commercial Bldg,Etc.J /gr1 bri.4 C
IS USE: PRIMARYIR SEASONAL❑ NUMBER OF BEDROOMS I NUMBER OF BATHROOMS—1-
HEATED STRUCI.U1tE? YES(Whole Bldg), YES(Pail(s)of Bldg)❑ NO
DESCRIBE WORK J NMFAC11, '0A1 ?04 C^rYaOhgym oicda)
SQUARE FOOTAGE:(proposed) ' /
1ST FLOOR 60 sq.ft. 2ND FLOOR /V/4 sq.ft. 3RD FLOOR /L/tk sq.ft. BASEMENT 1 46i-sq.ft.
DECK k/la, sq.ft. COVERED DECK V I a sq.ft. STORAGE_lit ft. OTHER 4A sq.ft.
GARAGE NI(.:4- sq.ft. Attached❑ Detached❑ CARPORT N� sq.ft. Attached 0 Detached❑
MANUFACTURED HOME INFORMAT�OiD�O` by r, . ear �I. ) J�i 89
MAKE F ,} (y AD{/ MODEL .GATAR 7��c
WIDTH)3 8// BEDROOMS I BATHS 1 SERIAL NUMBER ? 4(,7 ELvt 4*!r
ENVIRONMENTAL HEALTH:
SEWAGE/SEWER SOURCE: SEPTIC$ SEWER❑ / NEW X EXISTING❑
PLUMBING IN STRUCTURE? YES X NO❑ If yes.attach completed W er Adequacy Form
PERIMETER/FOUNDATION DRAINS PROPOSED?3 , YES 0 NO% XISTING SQ.FT 600
EXISTING BEDROOMS PROPOSED BEDROOMS Jh I TTOOTAL BEDROOMS al 1
OWNER acknowledges that submission of inaccurate information may result in a sto work order or permit revocation.Acknowledgement of such is by
signature below.I dedare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have
obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal
representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property
and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180
days or if construction work is suspended for a period of 180 days.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS
PERMIT APPLICATION OF 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
Cie
-- COUNTY CODE 14.08.42)
X k Cie /CI °,3/ao R,3
Si ature of OWNER(Must be signed by the OWNER) Date
DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS
BUILDING DEPARTMENT
PLANNING DEPARTMENT
FIRE MARSHAL _ ,�j�
PUBLIC HEALTH 17i1l�/t 2 J1`04
u. •
m
m▪ m D•o § I .91)
IIfD(D7 SC =
�
'CO fl. Oc 0
IA Oat C C;k O
a . G V �1
N 000
vl
3.co a c oN o W CO
3
0 0 o d 3 r79
n �
cu M [ • al
▪ 3▪ 0 = r*
O 7
3 a� n O =I
3 3 o rr'D 0_ l I i el
!^ ,-' 0301C ! ' fi
•
3 r I
I �— j I ! A
n a 'I • , I ) t I N C.9
1 . t II III i N
? s ; i . i I ' N 3
a a v 1y
K• a3 �. ( '
.. X tl I CD r
v 0 71.01
i _
no OFm
c Z __I ! : , IJI 1 I
1 al
i Fr; r _ t
m
y ; 3 rD J �; I •
aEI; it i
il rn
n ID 1
v -o' co -, � 1 I ff O
D O V
1 0i
n ,
fD i
n Cr)
-41
3 K m r L , Lw
w
a z
= -c n.
! II
3
:÷7 -.i
.
• S _
L d
v
ID 1 1 %1 F-�
3 O 1n \\ �� W
3 \\ zrD
M %v
a o -3
= n O
O• y 0
• Do 3
In co
-0 * w •
a st
c r.
H
°' p D
O 7 0
o z
.
likl
ii
1-1
a I It C ...
.I ,, 1!1 ; III I NN1 11 III Ii + I , I II!I Q
II III 1 1 It11 , -p
-�s3woH poomieeu 1 1 I 1 I I1 ,! 1 , 1 I i v -1 , —
a@r I ' T
II t• .• I r+ D rn
K
ro T1
I.._ 179..?._.� D o v
r
/01/ 4447 su,vsrr.N//.0 • ' 0 A) C Z
litco
D CI1
�oi �
o
•
.
N�
o o
o cc
Dowo
<
aNII I
0
(S. I
s4 4 7I •
71
° c o = (DM Q o
r I �, ? (�
cD o cD P.
j ,,� to ' " O � � om
it, mo N � 'O
w ' a
cc N =i
I` (I) (Q a V/
Bcr
co
D-
IM cD
o
o p o n W D
-Z3'zw0
l �
ao -•:o� �m
o m s=coo
a =
l 75' � o
1mma3on
`° 7
a 'vvm m
0 ff < il
_
En
D -Cm
/m
00
}--� 1 I ?•.N ut C 2 tr.;N S 'N N I_ O m
Q W a3 N N v, p m
7
. N o O N
O
A m y f.Tm Q w
$ +•
I z a ?o o
cD o 3 " n
°' < COd T
co m T
I • p •o O ^
�\
f " ao3 V)
.• J N + a o _
co �(9_o
m o
co d c
v o.
ao
f 7 R C
? O O
O Y No
Y